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Quantitative pretreatment VOI analysis of liver metastases 99mTc-MAA SPECT/CT and FDG PET/CT in relation with treatment response to SIRT

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Abstract
Using quantitive VOI analysis, the percentage Tc-99m-MAA uptake and SUVmax and mean values of liver metastases obtained prior to SIRT were related to treatment response using both a lesion-based and clinical dichotomous approach. Based on the VOI % of Tc-99m-MAA activity, the estimated Y-90-microspheres activity/cc (MBq/cc) was calculated from the effective dose injected. Baseline VOI FDG PET SUVmean and max values and estimated MBq/cc values were related to treatment response using a lesion-based approach (% change in SUVmean >= 50%) and a clinical dichotomous approach. Fifteen treatment sessions were analyzed (13 patients). Using the lesion-based approach (12 treatment sessions) 40 lesions responded and 37 did not. SUVmax and mean values proved significantly different between non-responding and responding lesions; 18:6 (SD 10.8) versus 13.5 (SD 8.4) for SUVmax (p = 0.02) and 11.4 (SD 3.8) versus 6.3 (SD 4.5) for SUVmean (p = 0.002). Using the clinical dichotomous approach (15 treatment sessions / 11 responding), 91 lesions were analyzed; 57 responded. VOI volumes and estimated Y-90-loaded glass microspheres activity (MBq/cc) did not differ between responders and non responders; 24 cc (SD 27) versus 21 cc (SD 21 cc) (p = 0.4) and 1.95 MBq/cc (SD 1.1 MBq/cc) versus 1.90 MB/cc (SD 2.7 MBq/cc) (p = 0.92). On the contrary, SUVmax and mean values proved significantly different between responders and non-responders; 23.7 (SD 9.8) versus 9.4 (SD 3.8) for SUVmax (p = 0.0001) and 13.1 (SD 8.1) versus 4.9 (SD 1.4) for SUVmean. Conclusion: These findings suggest that in patients presenting with high baseline SUVmax and mean values, the administration of higher activities or alternatively, other potentially more useful treatment options might be considered.
Keywords
NECK CANCER, THERAPY, METABOLISM, RADIOEMBOLIZATION, BREAST-CANCER, BLOOD-FLOW, SIRT-VOI analysis-treatment response, POSITRON-EMISSION-TOMOGRAPHY, LABELED RESIN MICROSPHERES, HUMAN TUMOR-CELLS, RADIOSENSITIVITY

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Chicago
Van De Wiele, Christophe, K Stellamans, E Brugman, Gilles Mees, Bart De Spiegeleer, Yves D’Asseler, L Beels, and A Maes. 2013. “Quantitative Pretreatment VOI Analysis of Liver Metastases 99mTc-MAA SPECT/CT and FDG PET/CT in Relation with Treatment Response to SIRT.” Nuklearmedizin-nuclear Medicine 52 (1): 21–27.
APA
Van De Wiele, Christophe, Stellamans, K., Brugman, E., Mees, G., De Spiegeleer, B., D’Asseler, Y., Beels, L., et al. (2013). Quantitative pretreatment VOI analysis of liver metastases 99mTc-MAA SPECT/CT and FDG PET/CT in relation with treatment response to SIRT. NUKLEARMEDIZIN-NUCLEAR MEDICINE, 52(1), 21–27.
Vancouver
1.
Van De Wiele C, Stellamans K, Brugman E, Mees G, De Spiegeleer B, D’Asseler Y, et al. Quantitative pretreatment VOI analysis of liver metastases 99mTc-MAA SPECT/CT and FDG PET/CT in relation with treatment response to SIRT. NUKLEARMEDIZIN-NUCLEAR MEDICINE. 2013;52(1):21–7.
MLA
Van De Wiele, Christophe, K Stellamans, E Brugman, et al. “Quantitative Pretreatment VOI Analysis of Liver Metastases 99mTc-MAA SPECT/CT and FDG PET/CT in Relation with Treatment Response to SIRT.” NUKLEARMEDIZIN-NUCLEAR MEDICINE 52.1 (2013): 21–27. Print.
@article{4263629,
  abstract     = {Using quantitive VOI analysis, the percentage Tc-99m-MAA uptake and SUVmax and mean values of liver metastases obtained prior to SIRT were related to treatment response using both a lesion-based and clinical dichotomous approach. Based on the VOI \% of Tc-99m-MAA activity, the estimated Y-90-microspheres activity/cc (MBq/cc) was calculated from the effective dose injected. Baseline VOI FDG PET SUVmean and max values and estimated MBq/cc values were related to treatment response using a lesion-based approach (\% change in SUVmean {\textrangle}= 50\%) and a clinical dichotomous approach. Fifteen treatment sessions were analyzed (13 patients). Using the lesion-based approach (12 treatment sessions) 40 lesions responded and 37 did not. SUVmax and mean values proved significantly different between non-responding and responding lesions; 18:6 (SD 10.8) versus 13.5 (SD 8.4) for SUVmax (p = 0.02) and 11.4 (SD 3.8) versus 6.3 (SD 4.5) for SUVmean (p = 0.002). Using the clinical dichotomous approach (15 treatment sessions / 11 responding), 91 lesions were analyzed; 57 responded. VOI volumes and estimated Y-90-loaded glass microspheres activity (MBq/cc) did not differ between responders and non responders; 24 cc (SD 27) versus 21 cc (SD 21 cc) (p = 0.4) and 1.95 MBq/cc (SD 1.1 MBq/cc) versus 1.90 MB/cc (SD 2.7 MBq/cc) (p = 0.92). On the contrary, SUVmax and mean values proved significantly different between responders and non-responders; 23.7 (SD 9.8) versus 9.4 (SD 3.8) for SUVmax (p = 0.0001) and 13.1 (SD 8.1) versus 4.9 (SD 1.4) for SUVmean. Conclusion: These findings suggest that in patients presenting with high baseline SUVmax and mean values, the administration of higher activities or alternatively, other potentially more useful treatment options might be considered.},
  author       = {Van De Wiele, Christophe and Stellamans, K and Brugman, E and Mees, Gilles and De Spiegeleer, Bart and D'Asseler, Yves and Beels, L and Maes, A},
  issn         = {0029-5566},
  journal      = {NUKLEARMEDIZIN-NUCLEAR MEDICINE},
  language     = {eng},
  number       = {1},
  pages        = {21--27},
  title        = {Quantitative pretreatment VOI analysis of liver metastases 99mTc-MAA SPECT/CT and FDG PET/CT in relation with treatment response to SIRT},
  url          = {http://dx.doi.org/10.3413/Nukmed-0514-12-07},
  volume       = {52},
  year         = {2013},
}

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